Age Patterns in Self-Reported Cognitive Impairment Among Older Latino Subgroups and Non-Latino Whites in the United States, 1997-2018: Implications for Public Health Policy.
Age Patterns in Self-Reported Cognitive Impairment Among Older Latino Subgroups and Non-Latino Whites in the United States, 1997-2018: Implications for Public Health Policy.
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DOI：
10.1093/geroni/igab039
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发表时间：
2021
影响因子：
7
通讯作者：
Raji M
中科院分区：
文献类型：
--
作者：
Garcia MA;Warner DF;García C;Downer B;Raji M
美国拉丁美洲人是一个异质性的人口，具有与基于出生状态和原籍国的个人社会经济和背景因素相关的独特特征。人口老龄化和公众对痴呆症的认识提高可能导致自我报告的认知障碍的患病率增加。然而，拉丁美洲人自我报告的认知障碍的人口水平趋势尚不清楚，也不知道拉丁美洲人亚群之间是否存在差异。因此，本研究的目的是检查异质性自我报告的认知功能障碍之间的老年美国拉丁裔亚组。我们使用了1997-2018年全国健康访谈调查的数据，记录了美国自我报告的认知障碍的年龄特异性模式。出生的墨西哥人，外国出生的墨西哥人，岛上出生的波多黎各人，外国出生的古巴人和美国人- 60岁及以上的非拉丁裔白人。我们估计了分层年龄-时期-队列交叉分类随机效应模型（HAPC-CCREM），以分离拉丁美洲亚组和美国亚组中自我报告的认知障碍的年龄模式。非拉丁裔白人自我报告的认知障碍的总体患病率从1997年的6.0%增加到2018年的7.1%。这一增长在美国-出生于非拉丁裔白人和美国-出生和外国出生的墨西哥人，但不是其他拉丁美洲亚群。完全校正的HAPC-CCREM估计值表明，拉丁裔比美国出生的非拉丁裔白人更有可能自我报告认知障碍（B = 0.371，p < .001）。当按拉丁裔亚组分类时，与美国相比，自我报告的认知障碍的可能性差异-出生的非拉丁裔白人在岛上出生的波多黎各人中最大（B = 0.598，p < .001），在外国出生的古巴人中最小（B = 0.131，p > .05）。我们发现，在美国拉丁裔亚组中，自我报告的认知障碍的年龄模式存在相当大的异质性。我们还发现，与美国拉丁裔亚组相比，美国拉丁裔亚组自我报告的认知障碍的可能性存在很大差异。非拉丁裔白人这些结果强调了在研究认知功能的人口水平趋势时区分独特拉丁裔亚群的重要性。
U.S. Latinos are a heterogeneous population with unique characteristics related to individual-level socioeconomic and contextual factors based on nativity status and country of origin. Population aging and greater public awareness of dementia may contribute to an increasing prevalence of self-reported cognitive impairment. However, population-level trends in self-reported cognitive impairment among Latinos are unclear and it is unknown whether there are differences among Latino subgroups. Thus, this study aims to examine heterogeneity in self-reported cognitive impairment among older U.S. Latino subgroups. We used data from the 1997–2018 National Health Interview Survey to document age-specific patterns in self-reported cognitive impairment among U.S.-born Mexican, foreign-born Mexican, island-born Puerto Rican, foreign-born Cuban, and U.S.-born non-Latino Whites aged 60 and older. We estimated hierarchical age–period–cohort cross-classified random effects models (HAPC-CCREM) to isolate age patterns in self-reported cognitive impairment across disaggregated Latino subgroups and U.S.-born non-Latino Whites. The overall prevalence of self-reported cognitive impairment increased from 6.0% in 1997 to 7.1% in 2018. This increase was evident among U.S.-born non-Latino Whites and U.S.-born and foreign-born Mexicans but not other Latino subgroups. Fully adjusted HAPC-CCREM estimates indicated that Latinos were more likely to self-report cognitive impairment than U.S-born non-Latino Whites (b = 0.371, p < .001). When disaggregated by Latino subgroup, the difference in the likelihood for self-reported cognitive impairment compared to U.S.-born non-Latino Whites was greatest for island-born Puerto Ricans (b = 0.598, p < .001) and smallest for foreign-born Cubans (b = 0.131, p > .05). We found evidence of considerable heterogeneity in the age patterns of self-reported cognitive impairment among U.S. Latino subgroups. We also detected large differences in the likelihood for self-reported cognitive impairment between U.S. Latino subgroups compared to U.S.-born non-Latino Whites. These results underscore the importance of differentiating between unique Latino subpopulations when studying population-level trends in cognitive function.
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